老年男性逼尿肌活动低下的尿动力学和临床特点分析  

The analysis of urodynamic and clinical features of detrusor underactivity in elderly men

作　　者：张艳[1] 张瑞莉[1] 孟令峰[2] 张艳平 王庆伟[1] 贾亮花[1] 张耀光[2] 窦启锋[3] 文建国[1] Zhang Yan;Zhang Ruili;Meng Lingfeng;Zhang Yanping;Wang Qingwei;Jia Lianghua;Zhang Yaoguang;Dou Qifeng;Wen Jianguo(Department of Urology and Urodynamic Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Urology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)

机构地区：[1]郑州大学第一附属医院泌尿外科和尿动力学中心,郑州450052 [2]北京医院泌尿外科国家老家医学中心中国医学科学院老年医学研究院,北京100730 [3]新乡医学院第一附属医院泌尿外科,卫辉453100

出　　处：《中华老年医学杂志》2021年第7期886-889,共4页Chinese Journal of Geriatrics

基　　金：2018年河南省医学科技攻关计划省部共建项目(编号:SBGJ2018059)。

摘　　要：目的分析60岁以上老年男性逼尿肌活动低下的尿动力学参数和临床表现特点.方法回顾性分析我院因排尿功能障碍行尿动力学测定的60岁以上男性573例.根据尿动力学参数逼尿肌收缩力指数(BCI)和膀胱出口梗阻指数(BOOI),按照以下分组标准将患者分为逼尿肌活动低下不伴膀胱出口梗阻组(DU):BCI<100和BOOI<20;膀胱出口梗阻不伴逼尿肌活动低下组(BOO):BCI≥100和BOOI≥40;和既不伴膀胱出口梗阻又不伴逼尿肌活动低下组(NDB):BCI≥100和BOOI<20.对比分析三组之间尿动力学参数和主要临床资料.结果共323例患者符合以上分组标准:DU组75例,BOO组207例和NDB组41例.DU组和BOO组年龄大于NDB组(P<0.05).DU组较NDB组初始排尿感容量偏大[(279±80)ml和(238±72)ml],尿不尽(41%和17%),尿线中断(39%和15%)和尿潴留(26%和7%)比例偏高,而膀胱排空率[(61±32)%和(110±41)%]偏低(均P<0.05).DU组初始排尿感容量和最大膀胱测压容量较BOO组偏大[(279±80)ml和(353±113)ml和(206±67)ml和(281±94)ml],尿线中断(39%和22%),经尿道前列腺电切术(26%和6%)和尿潴留(26%和14%)比例偏高,而膀胱排空率[(61±32)%和(78±37)%],逼尿肌不稳定(41%和77%),尿急(26%和43%)和夜尿增多(23%和39%)比例偏低(均P<0.05).结论膀胱感觉和膀胱排空率降低、尿线中断、尿潴留和有经尿道前列腺电切术史是老年男性DU患者主要尿动力学和临床表现特点.随着年龄的增长,男性DU和BOO患者比例随之增高.Objective To analyze the urodynamic and clinical features of detrusor underactivity(DU)in elderly men aged 60 years and over.Methods Five hundred and seventy-three men aged 60 years and over underwent urodynamic measurements due to dysuria were retrospectively:analyzed.According to the urodynamic parameters of bladder contracibility index(BCI)and bladder outlet obstruction index(BOOI),they were divided into the three groups:only detrusor underactivity(DU group)(BCI<100 and BOOI<20).only bladder outlet obstruction BOO group)(BCI≥100 and BOO1I≥40),and the combined non-DU and non-BOO group(NDB group)(BCI≥100 and BOO1<20).The urodynamic and elinical features were compared between the three groups.Results The internalized 323 patients meeting inclusion and exclusion criteria were divided into 3 groups:75 in the DU,207 in the BOO and 41 in the NDB.The age was higher in DU and BOO groups than in NDB group(P<0.05).The DU group versus the NDB group showed the higher levels or values in the volume at first desire(FDV)[(279±80)ml vs.(238±72)ml].the proportions of incomplete bladder emptying(41%vs.17%).urine flow interruption(39%vs.15%)and retention(26%vs.7%).and the lower levels in the voiding fficiency(VE)[(61±32)%vs.(110±41)%]all P<0.05).The DU group vs.the BOO group showed the increased levels or values in the FDV[(279±80)ml vs.(206±67)ml]and ma ximum cytometrice capacity(MCC)(353±113 ml vs.281±94 ml)and the proportions of urine flow interruption(39%vs.22%),TURP(26%vs.6%),and retention(26%vs.14%).and the decreased levels or values in the VE[(61±32)%vs.(78±37%)],the proportions of DO(41%vs.77%).urgency(26%vs.43%)and nocturia(23%vs.39%)(all P<0.05).Conclusions The main urodynamic and elinical features are manifested as the reduction of bladder sensation and bladder emptying rate.urine flow interruption.urinary retention and having a TURP history in elderly man with detrusor underactivity.The proportions of DU and BO0 are increased along with aging.

关 键 词：男性 逼尿肌活动低下 尿动力学 

分 类 号：R69[医药卫生—泌尿科学]